• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.243-255
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• 2019

Objective : Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS. Results : The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant. Conclusion : To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.

• 한국정보통신학회논문지
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• 제26권6호
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• pp.827-833
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• 2022

본 연구는 교통정보를 수집하기 위한 검지기 와 돌발 상황 검지에 사용되는 다양한 알고리즘들의 분석을 통해 기존 교통정보 수집체계의 한계를 극복하여 심각도가 높은 2차 교통사고를 예방하고자 한다. 즉 본 연구는 2차 교통사고를 유발하는 돌발 상황과 기존 교통정보 수집체계를 분석하고 그에 알맞은 2차 교통사고의 선제적 예방이 가능한 솔루션 및 도로 전 구간에 대한 정확한 정보수집이 가능한 지능화된 새로운 교통정보 수집 및 전달체계를 제시한다. 실험결과 데이터 전송 신뢰도는 95% 기준 97%를, 데이터 전송 속도는 1000ms 기준 평균 209ms, 네트워크 장애복구 시간은 120sec 기준 50sec의 목표치를 달성하였다.

• 대한교통학회지
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• 제34권1호
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• pp.68-80
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• 2016

본 연구는 다양한 교통상황에서의 오르막차로의 안전성 측면을 고려하여 운영기준 수립 및 운영 알고리즘을 개발하고자 하였다. 교통량과 중차량 비율에 따른 시나리오를 설정하고, 미시적 교통류 시뮬레이션으로 구현하여 분석을 수행하였으며, 오르막차로 개폐여부에 따른 안전성을 평가하였다. 안전성을 평가하기 위하여 교통상충건수와 상충심각도를 평가지표(SSM:Surrogate Safety Measure)로 사용하였다. 분석결과, 서비스 수준이 낮고 중차량 비율이 증가할수록 교통상충건수가 증가하였으며, 서비스수준이 높고 중차량 비율이 증가할수록 상충 심각도가 높아짐을 보였다. 이를 바탕으로 교통 안전성 측면을 고려한 오르막차로 개 폐 기준 및 탄력적 운영을 위한 알고리즘을 제시하였다. 본 연구결과를 활용할 경우, 기존의 운영효율성 측면과 안전성측면 동시에 고려할 수 있는 효율적인 오르막차로 운영이 가능할 것이며, 교통사고 감소 효과도 기대할 수 있을 것이다. 또한 갓길차로, 공사구간관리 등 LCS 운영시 안전성 측면을 고려한 전략적 운영을 지원할 수 있을 것이다.

• 대한토목학회논문집
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• 제34권1호
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• pp.223-233
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• 2014

본 연구는 도로 교통전문가에 대한 개인속성 및 운전행태를 비롯한 회전교차로 주행경험에 따른 만족도에 영향을 미칠 것으로 예상되는 요인들을 분석하였다. 회전교차로의 주행환경 만족도 특성을 명확하게 규명하기 위해 주성분분석을 실시하여 구성요인을 추출하고 변수들을 3개의 요인으로 그룹화하였으며, 각 그룹을 만족요인속성, 운전행태속성, 개인속성으로 명명하였다. 변수들의 신뢰성과 타당성을 검증하기 위해 확인적 요인분석을 통하여 변수정제과정을 거친 후 회전교차로 주행성 인지와 만족요인속성을 내생잠재변수로, 개인속성과 운전행태속성을 외생잠재변수로 구조화한 회전교차로 주행환경 만족도 모형을 개발하였다. 모형 추정결과, 회전교차로 주행만족도는 차량지체 감소, 교통안전성 향상, 도로용량 증대, 도시미관 개선, 교통환경 개선, 심각사고 감소, 자전거 이용 편의 등 만족요인속성에 직접적인 영향을 받으며 성별, 연령, 운전시간, 운전경력 등 개인속성에 간접적인 영향을 받는 것으로 분석되었다. 교통법규 준수, 양보운전, 교통표지 준수, 끼어들기 운전 등 운전행태속성은 주행 만족도에 통계적으로 유의한 영향을 끼치지 못하였다. 그리고 AHP분석결과, 회전교차로 안전성 확보를 위해서는 기하구조의 회전반경과 운전자특성의 운전습관이 가장 중요한 요소로 선정되었다.

• Journal of Trauma and Injury
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• 제29권1호
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• pp.1-7
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• 2016

Purpose: Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma. Methods: From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups. Results: In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was $6.89{\pm}1.59$ (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was $24.36{\pm}7.16$ (range: 11-34) in the blunt group; the mean RTS was $7.56{\pm}0.41$ (range: 7.11-7.84), and the mean ISS was $13{\pm}5.26$ (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups. Conclusion: Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma.

• 대한교통학회지
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• 제26권2호
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• pp.47-56
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• 2008

2차로도로는 우리나라 포장도로의 80% 이상을 차지하고 있기 때문에 2차로도로가 국내의 교통흐름에 있어서 차지하고 있는 비중은 매우 높다할 수 있다. 그러나 2차로도로는 진행방향당 한 차로만이 허용되어 있어 저속차량에 의해 지체가 발생할 경우 고속차량이 대향차로를 이용하여 추월해야 한다. 이러한 추월은 교통사고를 유발할 가능성이 매우 높으며 추월에 의한 사고는 중앙선 침범에 의한 정면 충돌사고를 일으킬 수 있으므로 사고의 심각도 또한 매우 높다할 수 있다. 그러나 2차로도로의 전반적인 운영상태 등을 나타내는 서비스수준에 대하여 현행 KHCM 에서는 '서비스수준이란 통행속도, 통행시간, 통행자유도, 안락감 그리고 교통안전 등 도로의 운행상태를 설명'하는 개념으로 정의하고 있지만 실제 서비스수준을 산정함에 있어서 서비스수준의 개념에 나타나 있는 바와는 달리 총지체율만을 이용하여 서비스수준을 산정하기 때문에 지체만을 고려하고 사고(교통안전)를 고려하지 않고 있다. 따라서 본 연구에서는 기존의 서비스수준 산정방법인 총지체율을 이용하여 지체시간을 산정하는 방법을 제시한 후, 여기에 지체비용을 곱하는 방식으로 총지체비용을 산출하는 방법을 제시하며 사고를 고려하기 위해 교통사고예측모형을 통하여 교통사고건수를 예측하고 여기에 평균교통사고비용을 곱하는 방식으로 총교통사고비용을 산출하는 방법을 제시한다. 마지막으로 앞에서 산출된 총지체비용과 총사고비용을 합산하여 운영비용을 산출함으로써 지체와 사고를 고려한 서비스수준의 새로운 판정척도를 개발하고 더불어 서비스수준을 제시하였다.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.215-218
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• 2012

Objective: Traumatic epidural hematomas (EDHs) in children are a relatively unusual occurrence. The cause and outcome vary depending on period and reg ion of study. The aims of this analysis were to review the cause and outcome of pediatric EDHs nowadays and to discuss outcome-related variables in a large consecutive series of surgically treated EDH in children. Methods: This is a retrospective review of 29 patients with surgically treated EDHs between Jan 2000 and February 2010. Patients' medical records, computed tomographic (Cl) scans, and, if performed, magnetic resonance imaging (MRI) were reviewed to define variables associated with outcome. Variables included in the analysis were age, associated severe intracranial injury, abnormal pupillary response, hematoma thickness, severity of head injury (Glasgow Coma Scale score), parenchymal brain injury, and diffuse axonal injury. Results: The mean (SO) age of the patients was 109 months (0-185 months). Most of the injuries with EDHs occurred in traffic accident (14 cases, 48.2%) and followed by slip down in 6 cases and falls in 6 cases. There were one birth injury and one unknown cause. EDHs in traffic accidents occurred in pedestrians hit by a motor vehicle, 9 cases; motorbike and car accidents, 5 cases and bicycle accidents, 1 case. The locations of hematoma were almost same in both sides (left side in 15 cases). Temporal lobe is the most common site of hematomas (13 cases, 44%). The mean size of the EDHs was 18 mm (range, 5-40 mm). Heterogeneous hematomas in CT scans were 20 cases (67%). Two patients were referred with unilateral or bilateral dilated pupil(s). There was enlargement of EDH in 5 patients (17%). All of them were heterogeneous hematomas in CT scans. Except for 4 patients, all EDHs were associated with skull fracture(s) (87%). There was no case of patient with major organ injury. CT or MRI revealed brain contusion in 5 patients, and diffuse axonal injury in one patient The mortality was zero, and the outcomes were excellent in 26 and good in 2 patients. None of the tested variables were found to have a prognostic relevance. Conclusion: Regardless of the EDH size, the clinical status of the patients, the abnormal pupillary findings, or the cause of injury, the outcome and prognosis of the patients with EDH were excellent.

• Journal of Acupuncture Research
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• 제33권4호
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• pp.15-31
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• 2016

Objectives : The aim of this study is to review the instruments used to assess patient condition and the effects of Korean medical treatment for patients injured in traffic accidents in clinical studies in the Korean medical field published in South Korea. Methods : A literature study was performed, and clinical studies on patients injured in traffic accidents visiting Korean medical clinics or hospitals were examined. Data about chief complaints, tools used to assess either patients' condition or the effectiveness of Korean medical treatment, and time point of assessment were extracted. The studies were classified according to symptom. The use-frequency and the parent category of the assessment tools were also analyzed. Results : 78 studies were selected and classified into 5 categories based on the chief complaints, neck pain, lower back pain, headache, psychological symptoms and unspecified symptoms. Various scales were used to report the patient's pain severity, and functional or psychological status resulting from traffic accidents. Pain index, in particular VAS, was most frequently used and a few mechanical instruments and Korean medicinal assessment tools were mentioned. Conclusion : Most instruments used in Korean medicine clinical studies on patients injured in traffic accidents are self-reported tools. To assess both the patient's condition precisely and the effectiveness of Korean medical treatment on patients injured in traffic accidents, more appropriate and unified tools should be designed that consider pain, functional disability, psychological status and objective assessments measured by devices together.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.243-247
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• 2013

Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.57-62
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• 2010

Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.